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The nurse is assessing clients in an outpatient diabetic clinic. Which entry provides the best evidence that the client is adhering to the prescribed diabetic regimen?
- A. Hemoglobin A1C of 6.2%
- B. Fasting blood glucose of 130 mg/dL
- C. Positive urine ketones
- D. Self-reported daily blood glucose monitoring
Correct Answer: A
Rationale: A hemoglobin A1C of 6.2% indicates good glycemic control, reflecting adherence to the diabetic regimen.
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The differential diagnosis of the patient includes all of the following EXCEPT
- A. rheumatic fever
- B. SLE
- C. chronic atrial fibrillation
- D. postmeningococcal immune complexes
Correct Answer: C
Rationale: Chronic atrial fibrillation is unlikely in an 8-year-old with acute onset symptoms.
Toxoplasma gondii infection in humans causes:
- A. Oral ulcers
- B. Cervical lymphadenopathy
- C. Microcephaly
- D. Chorioretinitis
Correct Answer: D
Rationale: Chorioretinitis is a hallmark of congenital toxoplasmosis, leading to vision impairment.
The parents of a young child with heart failure tell the nurse that they are “nervous†about giving digoxin (Lanoxin). The nurse’s response should be based on which statement?
- A. It is a safe, frequently used drug.
- B. It is difficult to either overmedicate or undermedicate with digoxin.
- C. Parents lack the expertise necessary to administer digoxin.
- D. Parents must learn specific, important guidelines for administration of digoxin.
Correct Answer: D
Rationale: Digoxin has a narrow therapeutic range. The margin of safety between therapeutic, toxic, and lethal doses is very small. Specific guidelines are available for parents to learn how to administer the drug safely and to monitor for side effects. Digoxin is a frequently used drug, but it has a narrow therapeutic range. Small amounts of the liquid are given to infants, making it easy to overmedicate or undermedicate. Parents may lack the necessary expertise to administer the drug at first, but with discharge preparation, they should be prepared to administer the drug safely.
To reduce the risk for pulmonary complications for a client with Amyotrophic Lateral Sclerosis (ALS), what interventions should the nurse implement?
- A. Initiate passive range of motion exercises
- B. Establish a regular bladder routine
- C. Teach the client breathing exercises
- D. Perform chest physiotherapy
Correct Answer: C
Rationale: Breathing exercises, chest physiotherapy, and use of an incentive spirometer can help reduce the risk of pulmonary complications in ALS by improving lung function.
Examples of cyanotic heart disease include:
- A. Ebstein's anomaly
- B. Pulmonary stenosis
- C. Coarctation of aorta
- D. Hypoplastic left heart syndrome
Correct Answer: D
Rationale: Hypoplastic left heart syndrome is a form of cyanotic heart disease. Ebstein's anomaly and pulmonary stenosis can also cause cyanosis, but coarctation of the aorta typically does not.